Individual
DR. ROSA ANITZA GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 349-4000
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
18739
MS
207P00000X
Emergency Medicine Physician
39201
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05273041
—
MS
01
—
1383U
BLUE CROSS
NC
05
—
3326869
—
TN
01
—
4097069
BLUE CROSS
TN
Enumeration date
06/08/2006
Last updated
11/30/2007
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